Crico: Plutôt une lame de 20 ?

Scalpel bougie tube versus hook-assisted emergency front of neck airway—a prospective randomised bench top study in porcine larynges

Caulfield K. et Al.  https://doi.org/10.1016/j.bja.2019.05.017 

 

Cette lettre a pour objet de comparer l'insertion d'une canule au travers de la membrane crico-thyroidienne d'un larynx de cochon (membrane que l'on sait relativement profonde) soit en utilisant un crochet de Hook soit une bougie. Les deux techniques se valent. Chose intéressante ils observent près de 17% de difficultés d'insertion avec une lame de 10 versus 7% avec une lame de 20. Cette dernière, qui est une version XL de la lame 10, semble donc préférable ?

 

 

"...In the Phase 1 study, the maximum sized ET tube to be placed into the CTM was a size 8. Time to insertion of ET tube averaged 30 s using a Size 20 blade and 31 s using a size 10 blade for all ETT sizes. There was a 16% recorded difficulty by candidates with the size 10 blade and only 7.5% recorded difficulty with the size 20 blade. In the Phase 2 study (blinded RCT), all attempted eFONA attempts were ultimately successful. There were no differences in time required, proportion successful in less than 40 s, or perceived difficulty between groups. Neither CTM incision width nor the proportion of attempts requiring re-incision was different between groups. Reassuringly, all eFONA attempts with both techniques were successful. Neither technique outperformed the other in any aspect of performance."